Epidemiology of Oral Cancer

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Module 1

• Epidemiology of Oral Cancer

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Epidemiology of Cancer, U.S.
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US Mortality, 2001
No. of deaths
of all deaths
Rank
Cause of Death

• 1. Heart Diseases 700,142 29.0
• 2. Cancer 553,768 22.9
• 3. Cerebrovascular diseases 163,538 6.8
• 4. Chronic lower respiratory diseases 123,013
  5.1
• 5. Accidents (Unintentional injuries) 101,537
  4.2
• 6. Diabetes mellitus 71,372 3.0
• 7. Influenza and Pneumonia 62,034 2.6
• 8. Alzheimers disease 53,852 2.2
• 9. Nephritis 39,480 1.6

Source US Mortality Public Use Data Tape 2001,
National Center for Health Statistics, Centers
for Disease Control and Prevention, 2003.
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2004 Estimated US Cancer Cases
Men699,560
Women668,470
32 Breast 12 Lung bronchus 11 Colon
rectum 6 Uterine corpus 4 Ovary
4 Non-Hodgkin lymphoma 4 Melanoma of
skin 3 Thyroid 2 Pancreas 2 Urinary
bladder 20 All Other Sites
Prostate 33 Lung bronchus 13 Colon
rectum 11 Urinary bladder 6 Melanoma of
skin 4 Non-Hodgkin
lymphoma 4 Kidney 3 Oral Cavity 3 Leukemia 3
Pancreas 2 All Other Sites 18
Excludes basal and squamous cell skin cancers
and in situ carcinomas except urinary bladder.
American Cancer Society, 2004.
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Lifetime Probability of Developing Cancer, by
Site, Men, US, 1998-2000
Site
Risk
All sites 1 in 2 Prostate 1 in 6 Lung
bronchus 1 in 13 Colon rectum 1 in
17 Urinary bladder 1 in 29 Non-Hodgkin
lymphoma 1 in 48 Melanoma 1 in 55 Kidney 1
in 69 Leukemia 1 in 70 Oral cavity 1 in 72
Source DevCan Probability of Developing or
Dying of Cancer Software, Version 5.1 Statistical
Research and Applications Branch, NCI, 2003.
http//srab.cancer.gov/devcan
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Lifetime Probability of Developing Cancer, by
Site, Women, US, 1998-2000
Site
Risk
All sites 1 in 3 Breast 1 in 7 Lung
bronchus 1 in 17 Colon rectum 1 in
18 Uterine corpus 1 in 38 Non-Hodgkin
lymphoma 1 in 57 Ovary 1 in
59 Pancreas 1 in 83 Melanoma 1 in
82 Urinary bladder 1 in 91 Uterine cervix 1
in 128
SourceDevCan Probability of Developing or Dying
of Cancer Software, Version 5.1 Statistical
Research and Applications Branch, NCI, 2003.
http//srab.cancer.gov/devcan
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Estimated New Oral Cancer Cases Deaths by Sex,
US, 2004
Estimated New
Cases Estimated Deaths
Both Sexes Male Female
Both Sexes Males Females All sites
1,368,030 699,560 668,470
563,700 290,890 272,810 Oral
cavity/pharynx 28,260 18,550 9,710
7,230 4,830 2,400 Tongue
7,320 4,860
2,460 1,700 1,100
600 Mouth 10,080
5,410 4,670 1,890 1,070
820 Pharynx 8,250
6,330 1,920 2,070
1,460 610 Other oral cavity
2,610 1,950 660 1,570
1,200 370
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What is oral cancer?

• Cancer that starts in the mouth is oral cavity
  cancer
• Includes lips
• Inside lining of cheeks (buccal mucosa)
• Gingiva (gums)
• Floor of the mouth
• Anterior 2/3rds of the tongue
• Hard palate

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Oropharyngeal cancer

• Refers to cancers that start in the oropharynx
  (posterior to the oral cavity)
• For convenience, these modules will refer to oral
  cavity and oropharyngeal cancers as oral cancer

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Oropharyngeal CancersStatistics for the United
States

• The American Cancer Society estimates 29,370 new
  cases of oral cavity and oropharyngeal cancer in
  2005
• About 7,320 will die from the disease during 2005

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Cancer Survival() by Site and Race,1992-1999
African
Site
White
Difference
American
All Sites 64 53 11 Breast
(female) 88 74 14 Colon
rectum 63 53 10 Leukemia 48
39 9 Non-Hodgkin lymphoma 57 47
10 Oral cavity 60 36
24 Prostate 99 93 6 Urinary
bladder 83 64 19 Uterine
cervix 73 61 12
5-year relative survival rates based on cancer
patients diagnosed from 1992 to 1999 and followed
through 2000. Source Surveillance, Epidemiology,
and End Results Program, 1975-2000, Division of
Cancer Control and Population Sciences, National
Cancer Institute, 2003.
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Incidence rates for oral and pharyngeal cancers
(1992-1997) by stage at diagnosis race/ethnicity
The totals in this figure include unstaged
cancers. Data source Surveillance, Epidemiology,
and End Results (SEER) 11 Registries Public-Use,
August 1999 Submission (1992-1997). The rates are
per 100,000 and are age-adjusted to the 1970 U.S.
standard population.
13.1.2
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Incidence rates for oral and pharyngeal cancers
(1992-1997) by stage at diagnosis and gender
The totals in this figure include the unstaged
cancers. Data source Surveillance, Epidemiology,
and End Results (SEER) 9 Registries Public-Use,
August 1999 Submission (1993-1997). The rates are
per 100,000 and are age-adjusted to the 1970 U.S.
standard population.
13.1.3
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Percentage of adults aged 40 and older who
reported having had an oral cancer examination in
the past year
Data source 1998 National Health Interview
Survey, National Center for Health Statistics,
Centers for Disease Control and Prevention.
13.2.1
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Oral and pharyngeal cancerdeaths (per 100,000)
in 1998 by race/ethnicity, gender and education
Age adjusted to the year 2000 U.S. standard
population. Data source 1998 National Vital
Statistics System, National Center for Health
Statistics, Centers for Disease Control and
Prevention.
13.3.1
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State of Illinois Statistics
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Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000
Incidence Incidence Incidence Incidence Incidence Incidence Mortality Mortality Mortality Mortality Mortality Mortality
Illinois Illinois Illinois SEER SEER SEER Illinois Illinois Illinois U.S. U.S. U.S.
Site Rate Count Rate Count Rate Count Rate Count
Lip 0.6 76 6.1 0.9 220 8.1 0.0 4 1.2 0.0 63 0.9
Tongue 2.5 294 23.4 2.6 663 24.5 0.7 80 24.4 0.6 1,687 23.6
Salivary Gland 1.1 132 10.5 1.3 344 12.7 0.2 27 8.2 0.2 636 8.9
Floor of Mouth 1.0 123 9.8 0.7 185 6.8 0.1 10 3.0 0.1 143 2.0
Gum/Other Mouth 1.6 192 15.3 1.8 445 16.4 0.5 57 17.4 0.4 1,156 16.1
Nasopharynx 0.6 77 6.1 0.7 169 6.2 0.2 22 6.7 0.2 628 8.8
Tonsil 1.3 154 12.3 1.3 337 12.5 0.2 25 7.6 0.2 493 6.9
Oropharynx 0.4 52 4.1 0.3 79 2.9 0.2 25 7.6 0.2 521 7.3
Hypopharynx 0.9 108 8.6 0.8 204 7.5 0.1 11 3.4 0.1 348 4.9
Other Oral Cavity 0.4 47 3.7 0.2 60 2.2 0.6 67 20.4 0.6 1,488 20.8
Total 10.5 1,255 100.0 10.6 2,706 100.0 2.7 328 100.0 2.7 7,163 100.0

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Stage at Diagnosis of Oral Cavity and
Oropharyngeal Cancer Incidence Average Annual
Percentages for 5-year Time Periods All Races,
Both Sexes, Illinois, 1986-2000
Source Illinois Department of Public Health,
Illinois State Cancer Registry, January 2003
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Incidence Mortality, Buccal Cavity and Pharynx,
Both Sexes, 1986-2000
State of Illinois
All Races All Races Whites Whites Blacks Blacks Asian/Other Asian/Other
Illinois Count Rate Count Rate Count Rate Count Rate
Incidence 18,201 10.9 14,693 10.1 3,014 14.9 307 8.2
Mortality 5,504 3.3 4,284 2.9 1,153 5.8 67 1.7
Illinois Department of Public Health, Illinois
State Cancer Registry, January 2003
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State of Illinois Statistics
Incidence Rate for Oral Cancer, 1993-1997 Incidence Rate for Oral Cancer, 1993-1997 Incidence Rate for Oral Cancer, 1993-1997 Incidence Rate for Oral Cancer, 1993-1997
Illinois Illinois US US
Women Men Women Men
5.3 14.4 5.9 15.3
American Cancer Society, 2004
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Illinois Statistics
Mortality Rate for Oral Cancer, 1993-1997 Mortality Rate for Oral Cancer, 1993-1997 Mortality Rate for Oral Cancer, 1993-1997 Mortality Rate for Oral Cancer, 1993-1997
Illinois Illinois US US
Women Men Women Men
1.3 4.3 1.4 3.8
American Cancer Society, 2004
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Stage at Diagnosis of Oral Cavity and
Oropharyngeal Cancer Incidence Average Annual
Percentages for 5-year Time Periods All Races,
Both Sexes, Illinois, 1986-2000

• Figure 11 Oral Cavity and Oropharyngeal Cancer
  Incidences, 1986-2000 (Site-Race-Ethnicity)
• Includes only invasive cancers.
  Hispanics/non-Hispanics are not mutually
  exclusive from whites, blacks and
• Asian/other races.Source Illinois Department of
  Public Health, Illinois State Cancer Registry,
  January 2003

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Oral Cavity and Oropharynx Average Annual
Age-adjusted Cancer Rates by Gender and
Race/Ethnicity in Illinois, Incidence and
Mortality, 1996-2000
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Percentage Cases Diagnosed at Early Stage Oral
Cavity and Oropharyngeal Cancer Incidence
Illinois Counties, 1986-2000
Figure 14 Oral Cavity and Oropharyngeal Cancer
Incidence in Illinois Counties (1986-2000)
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Summary

• Oropharyngeal cancers are prevalent throughout
  the U.S. and in the State of Illinois
• Men face a greater risk than women, with African
  American men facing the greatest risk